title: Does the great saphenous vein stripping improve arterial leg blood flow during exercise?
abstract: OBJECTIVE
  It has been shown that the leg muscle pump increases arterial leg blood flow during upright exercise in healthy subjects, and that this effect is reduced in patients with incompetence of the great saphenous vein (GSV). In this study, patients with GSV reflux causing varicose veins were investigated after GSV stripping, to see whether the muscle pump effect on arterial leg blood flow is improved.
  
  
  METHODS
  Prospective case study.
  
  
  METHODS
  Nine patients with GSV incompetence resulting in symptomatic varicose veins, but without peripheral artery disease were included in this study. Patients exercised in the supine and 30° head up tilted positions by rhythmically pressing down a pedal with one foot. Blood flow was measured in the femoral artery using Doppler ultrasound. The Exercise-induced rise in femoral artery blood flow was compared in the supine and 30° head up tilted positions. Patients were investigated both before and after undergoing saphenofemoral ligation and GSV stripping as a treatment for their varicose veins. The arterial blood flow response to exercise was compared between the pre and postoperative observations.
  
  
  RESULTS
  Prior to GSV stripping the immediate rise in femoral flow was 0.25 l min(-1) above rest in both supine and tilted positions. After GSV stripping however, the rise in flow was 30% larger in the tilted position than in the supine position (0.26 vs. 0.20 l min(-1), P < 0.05).
  
  
  CONCLUSIONS
  GSV stripping modestly improves arterial leg blood flow at the onset of exercise in patients with GSV insufficiency, because of an improved effect of the leg muscle pump.
authors.affiliation: Institute of Basic Medical Sciences, Department of Physiology, University of Oslo, 0317 Oslo, Norway. i.h.nadland@medisin.uio.no
authors.forename: I H
authors.initials: IH
authors.lastname: Nådland
authors.forename: J
authors.initials: J
authors.lastname: Wesche
authors.forename: D D
authors.initials: DD
authors.lastname: Sheriff
authors.forename: K
authors.initials: K
authors.lastname: Toska
mesh_terms: D015444:Exercise / Q000502:physiology*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology*; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000502:physiology*; D018615:Ultrasonography, Doppler, Color; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000503:physiopathology*